Tracking of infant and young child feeding practices among 9-to 24-month-old children in Nepal: the MAL-ED Birth Cohort Study

Objective: The present study aimed to assess infant and young child feeding (IYCF) practices and the tracking of dietary diversity score (DDS), intakes of Fe- and vitamin A-rich foods and meal frequency in a peri-urban area in Nepal. Furthermore, to explore whether sociodemographic factors were associated with tracking patterns of these IYCF practices. Design: Longitudinal study. Monthly food intake was measured by 24 h recall. Four time slots were used (9-12, 13-16, 17-20 and 21-24 months). Tracking of IYCF practices was investigated using generalized estimating equations (GEE) models and Cohen's weighted kappa. Multinominal logistic regression was used to identify determinants for tracking of the IYCF practices. Setting: Bhaktapur municipality, Nepal. Subjects: Children (n 229) aged 9-24 months, randomly selected. Results: Prevalence of minimum meal frequency was higher than for minimum dietary diversity at all rime slots. Tracking based on absolute measures (GEE models) was moderate for DDS (0.48) and meal frequency (0.53), and low for intakes of Fe- (0.23) and vitamin A-rich (0.35) foods. Tracking based on rank measured was moderate for DDS and meal frequency, and fair for Fe- and vitamin A-rich foods. Low socio-economic status significantly increased the odds (OR; 95% CI) of tracking of low v. liigh DDS (3.31; 1.44, 7.60) and meal frequency (3.46; 1.54, 7.76). Conclusions: Low tracking for intakes of Fe- and vitamin A-rich foods implies that interventions to improve these IYCF practices must address underlying causes for irregular intake to have sustainable effects.